Customizable closed tissue site dressing for improved postoperative removal

ABSTRACT

Some illustrative embodiments of a dressing for treating a tissue site may include a fluid hub, a plurality of elongate fluid members, and a separable joint. The plurality of elongate fluid members may be positioned in fluid communication with the fluid hub. Each of the plurality of elongate fluid members may include a proximal end, a distal end, and an elongate side between the proximal end and the distal end. The elongate side of the elongate fluid members may extend longitudinally outward from the fluid hub. The separable joint may be coupled between the elongate side of one of the plurality of elongate fluid members and the elongate side of another of the plurality of elongate fluid members. Other dressings, systems, and methods are disclosed.

RELATED APPLICATIONS

This application is a Divisional of U.S. patent application Ser. No.15/546,268, filed Jul. 25, 2017, which is a U.S. National Stage Entry ofPCT/US2016/014645, filed Jan. 23, 2016, which claims the benefit, under35 USC 119(e), of the filing of U.S. Provisional Patent Application No.62/110,870, entitled “Customizable Closed Tissue Site Dressing forImproved Postoperative Removal,” filed Feb. 2, 2015, which areincorporated herein by reference for all purposes.

FIELD

This disclosure relates generally to medical treatment systems and, moreparticularly, but not by way of limitation, to systems, dressings,devices, and methods that may be suitable for treating a tissue site.

BACKGROUND

Depending on the medical circumstances, reduced pressure may be usedfor, among other things, reduced-pressure therapy to encouragegranulation at a tissue site, draining fluids at a tissue site, closinga wound, reducing edema, promoting perfusion, and fluid management.Challenges can exist with extracting fluids from a tissue site underreduced-pressure therapy. For example, tissue sites may vary in volume,size, geometry, orientation, and other factors. Further, access to thesetissue sites may be restricted. These and other factors can makeextraction of waste fluids from the tissue site difficult to perform.

Types of tissue sites that may present particular difficulties mayinclude locations such as a peritoneal cavity, and more generally, anabdominal cavity. For example, the abdominal cavity can be prone tocomplications such as peritonitis, abdominal compartment syndrome, andinfections that can inhibit healing. Thus, improvements to treatmentsystems that may adapt to various types of tissue sites andorientations, reduce the invasiveness of the treatment, and increaseefficiency and healing times may be desirable.

SUMMARY

In some illustrative embodiments, a system for treating a tissue sitemay include a fluid hub, a plurality of elongate fluid members, aseparable joint, a pneumatic connector, and a reduced-pressure source.The plurality of elongate fluid members may be positioned in fluidcommunication with the fluid hub. Each of the plurality of elongatefluid members may include a proximal end, a distal end, and an elongateside between the proximal end and the distal end. The elongate side ofthe plurality of elongate fluid members may extend longitudinallyoutward from the fluid hub. The separable joint may be coupled betweenthe elongate side of one of the plurality of elongate fluid members andthe elongate side of another of the plurality of elongate fluid members.The pneumatic connector may be positioned in fluid communication withthe plurality of elongate fluid members. The reduced-pressure source maybe adapted to be positioned in fluid communication with the pneumaticconnector.

In some illustrative embodiments, a dressing for treating a tissue sitemay include a fluid hub, a plurality of elongate fluid members, and aseparable joint. The plurality of elongate fluid members may bepositioned in fluid communication with the fluid hub. Each of theplurality of elongate fluid members may include a proximal end, a distalend, and an elongate side between the proximal end and the distal end.The elongate side of the elongate fluid members may extendlongitudinally outward from the fluid hub. The separable joint may becoupled between the elongate side of one of the plurality of elongatefluid members and the elongate side of another of the plurality ofelongate fluid members.

In some illustrative embodiments, a dressing for treating a tissue sitemay include a fluid hub, a first elongate fluid member, a secondelongate fluid member, a separable joint, and a pneumatic connector. Thefirst elongate fluid member may include a first proximal end, a firstdistal end, and a first elongate side defined between the first proximalend and the first distal end. The first distal end may be coupled influid communication to the fluid hub. The second elongate fluid membermay include a second proximal end, a second distal end, and a secondelongate side defined between the second proximal end and the seconddistal end. The second proximal end may be coupled in fluidcommunication to the fluid hub. The separable joint may be coupledbetween the first elongate side and the second elongate side and may beconfigured to releasably couple the first elongate side to the secondelongate side. The pneumatic connector may be coupled in fluidcommunication at the first proximal end of the first elongate fluidmember. Further, the pneumatic connector and the first proximal end ofthe first fluid member may be in fluid communication with the seconddistal end of the second fluid member through the fluid hub.

In some illustrative embodiments, a method for treating a tissue sitemay include providing a dressing. The dressing may include a pluralityof elongate fluid members and a pneumatic connector. The plurality ofelongate fluid members may include a proximal end, a distal end, and anelongate side between the proximal end and the distal end. The pneumaticconnector may be positioned in fluid communication with the plurality ofelongate fluid members. Further, the method may include positioning theplurality of elongate fluid members across the tissue site, andpositioning the pneumatic connector through an external opening of thetissue site. Further, the method may include moving a fluid from thetissue site along the plurality of elongate fluid members to thepneumatic connector, and extracting the fluid through the pneumaticconnector. Further, the method may include removing the plurality ofelongate fluid members from the tissue site through the external openingby applying a removal force to the pneumatic connector.

In some illustrative embodiments, a method for removing a dressing froma tissue site may include providing the dressing positioned at thetissue site. The dressing may include a plurality of elongate fluidmembers, a pneumatic connector, and a separable joint. The plurality ofelongate fluid members may include a proximal end, a distal end, and anelongate side between the proximal end and the distal end. The pluralityof elongate fluid members may be positioned across the tissue site. Thepneumatic connector may be positioned in fluid communication with theplurality of elongate fluid members. The pneumatic connector may extendthrough an external opening of the tissue site. The separable joint maybe coupled between the elongate side of one of the plurality of elongatefluid members and the elongate side of another of the plurality ofelongate fluid members. Further, the method may include removing theplurality of elongate fluid members from the tissue site through theexternal opening by applying a removal force to the pneumatic connector.

In some illustrative embodiments, a method for placing a dressing at atissue site may include providing a dressing. The dressing may include aplurality of elongate fluid members and a pneumatic connector. Theplurality of elongate fluid members may include a proximal end, a distalend, and an elongate side between the proximal end and the distal end.The pneumatic connector may be positioned in fluid communication withthe plurality of elongate fluid members. Further, the method may includepositioning the plurality of elongate fluid members across the tissuesite, and positioning the pneumatic connector through an externalopening of the tissue site. Positioning the plurality of elongate fluidmembers across the tissue site may include spacing the elongate side ofat least one of the elongate fluid members apart from the elongate sideof another of the elongate fluid members.

Other aspects, features, and advantages of the illustrative embodimentswill become apparent with reference to the drawings and detaileddescription that follow.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partial cut-away view of an illustrative embodiment of asystem for treating a tissue site deployed at an illustrative tissuesite;

FIG. 2A is a plan view of an illustrative embodiment of a dressing shownin the system of FIG. 1, depicting an illustrative embodiment of aplurality of elongate fluid members coupled to one another forpositioning at the tissue site;

FIG. 2B is a cross-section of the dressing of FIG. 2A, taken along line2B-2B in FIGS. 1 and 2A;

FIG. 3 is a plan view of the dressing of FIG. 2A, depicting theplurality of elongate members disconnected and separated from oneanother;

FIG. 4A is another illustrative embodiment of a dressing suitable foruse with the system of FIG. 1;

FIG. 4B is a cross-section of the dressing of FIG. 4A, taken along line4B-4B in FIG. 4A;

FIG. 5A is a plan view of the dressing of FIG. 4A, depicting theplurality of elongate members disconnected and separated from oneanother; and

FIG. 5B is a perspective view of the dressing of FIG. 4A, depicting theplurality of elongate members disconnected from one another and gatheredtogether for removal from the tissue site.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

In the following detailed description of non-limiting, illustrativeembodiments, reference is made to the accompanying drawings that form apart hereof. Other embodiments may be utilized, and logical, structural,mechanical, electrical, and chemical changes may be made withoutdeparting from the scope of the appended claims. To avoid detail notnecessary to enable those skilled in the art to practice the embodimentsdescribed herein, the description may omit certain information known tothose skilled in the art. The following detailed description isnon-limiting, and the scope of the illustrative embodiments are definedby the appended claims. As used herein, unless otherwise indicated, “or”does not require mutual exclusivity.

Referring to FIG. 1, in some illustrative embodiments, a system 102 mayinclude a therapy device 104, a pneumatic connector 106, a sealingmember 108, and a dressing 110. In other embodiments, components of thesystem 102 may be omitted or added as appropriate for specificapplications. The system 102 may be suitable for providing reducedpressure treatment at a tissue site 116.

The tissue site 116 may be may be the bodily tissue of any human,animal, or other organism, including bone tissue, adipose tissue, muscletissue, dermal tissue, connective tissue, cartilage, tendons, ligaments,or any other tissue. The tissue site 116 may extend through or otherwiseinvolve an epidermis 118, a dermis 120, and a subcutaneous tissue 122.In some embodiments, the tissue site 116 may be a sub-surface tissuesite as depicted in FIG. 1 that extends below the surface of theepidermis 118. An external opening 117 may extend between the tissuesite 116 and an exterior of the tissue site 116 to permit, withoutlimitation, connection, placement, operation, or removal of componentsof the system 102. In other embodiments, the tissue site 116 may be asurface tissue site (not shown) that predominantly resides on a surfaceof the epidermis 118.

As shown in FIG. 1, the tissue site 116 may include tissue in a bodycavity such as, without limitation, an abdominal cavity 124. Theabdominal cavity 124 may include abdominal contents 126 or other tissueproximate the abdominal cavity 124. The dressing 110 may be disposed inthe abdominal cavity 124 and supported on a surface of the abdominalcontents 126. The dressing 110 may also be positioned in or proximate toa left lateral or first paracolic gutter 128 and a right lateral orsecond paracolic gutter 130. The first paracolic gutter 128 and thesecond paracolic gutter 130 may each be, for example, an open space onopposing sides of the abdominal cavity 124 among the abdominal contents126. The first paracolic gutter 128 may be laterally disposed from thesecond paracolic gutter 130 or otherwise positioned on an opposite sideof the tissue site 116 from the second paracolic gutter 130. Thepneumatic connector 106 may be adapted to be positioned at the externalopening 117 of the tissue site 116, for example, extending into theabdominal cavity 124. In some embodiments, the pneumatic connector 106may be adapted to extend through the external opening 117. Although FIG.1 depicts the system 102 deployed at the abdominal cavity 124, thesystem 102 may be used without limitation at other types of tissuesites. Further, the treatment of the tissue site 116 may include,without limitation, the removal of fluids, such as ascites and exudates,reduced-pressure therapy, instillation or distribution of fluids to thetissue site 116, and protection of the tissue site 116.

The therapy device 104 may be adapted to be positioned or coupled influid communication with the pneumatic connector 106 and the dressing110. In some illustrative embodiments, the therapy device 104 mayinclude a reduced-pressure source 136 and a canister 138. Further, insome embodiments, the therapy device 104 may optionally include and asensor 140 and a controller 146. The components of the therapy device104 may be arranged or associated with one another as shown in FIG. 1 toform the therapy device 104. However, in other embodiments (not shown),the components of the therapy device 104 may be provided separately orindependently from the therapy device 104. Further, components of thetherapy device 104 may be added or omitted as desired for a particularapplication.

The reduced-pressure source 136 may be adapted to be positioned orcoupled in fluid communication with the pneumatic connector 106 and thedressing 110. In some embodiments, the reduced-pressure source 136 maybe a pump, such as a portable pump. In other embodiments, thereduced-pressure source 136 may be any suitable device for providingreduced pressure, such as, for example, a wall suction source, a handpump, or other source.

The canister 138 may be positioned in fluid communication between thereduced-pressure source 136 and the pneumatic connector 106. Forexample, the reduced-pressure source 136 may be positioned in fluidcommunication with the pneumatic connector 106 and the dressing 110through the canister 138 such that fluid from the tissue site 116 andthe dressing 110 maybe drawn into the canister 138. The canister 138 maybe in fluid communication with a reduced-pressure inlet 148 of thereduced pressure source 136. The canister 138 may be any suitablecontainment device for holding or communicating fluids.

The sensor 140 may be, without limitation, a pressure sensor, atemperature sensor, or other sensor. The controller 146 may be, forexample, a processor or similar device configured to control componentsof the therapy device 104, and to monitor the treatment or state of thetissue site 116. The controller 146 may be electrically coupled in anysuitable manner to the reduced-pressure source 136, the sensor 140, orother components of the therapy device 104. For example, electricalconductors 150 may electrically couple the controller 146 to thereduced-pressure source 136 and the sensor as shown in FIG. 1. Thecontroller 146 may include software or user programmable settings forcontrolling components of the therapy device 104 in relation to oneanother. For example, the controller 146 may control reduced pressureoutput from the reduced-pressure source 136 according to a signalgenerated or received from the sensor 140. The signal from the sensor140 may be, for example, a pressure signal, a temperature signal, orother signal.

Reduced pressure may be applied to the tissue site 116 from thereduced-pressure source 136 to promote removal of ascites, exudates, orother fluids from the tissue site 116. Further, reduced pressure may beapplied to stimulate the growth of additional tissue. In the case of awound at the tissue site 116, the growth of granulation tissue, removalof exudates, or removal of bacteria may promote healing. In thesituation of a non-wounded or non-defective tissue, reduced pressure maypromote the growth of tissue that may be harvested and transplanted toanother tissue site.

As used herein, “reduced pressure” may refer to a pressure less than theambient pressure at a tissue site subject to treatment. In someembodiments, the reduced pressure may be less than the atmosphericpressure. The reduced pressure may also be less than a hydrostaticpressure at a tissue site. Unless otherwise indicated, values ofpressure stated herein are gauge pressures. The reduced pressuredelivered may be a constant pressure, varied pressure, intermittentpressure, or continuous pressure. Although the terms “vacuum” and“negative pressure” may be used to describe the pressure applied to atissue site, the actual pressure applied to the tissue site may be morethan the pressure normally associated with a complete vacuum. Anincrease in reduced pressure may correspond to a reduction in pressure(more negative relative to ambient pressure), and a decrease in reducedpressure may correspond to an increase in pressure (less negativerelative to ambient pressure). While the amount and nature of reducedpressure applied to a tissue site may vary according to the application,in some embodiments, the reduced pressure may be between about −5 mm Hgto about −500 mm Hg. In other embodiments, the reduced pressure may bebetween about −100 mm Hg to about −200 mm Hg. In yet other embodiments,the reduced pressure may be between about −50 mm Hg to about −300 mm Hg.

Further, in some embodiments, components of the system 102, such as,without limitation, the reduced-pressure source 136, the therapy device104, or the controller 146, may include preset selectors for an amountof reduced pressure, such as, for example, −100 mm Hg, −125 mm Hg, and−150 mm Hg. Further, the system 102 may also include a number of alarms,such as, for example, a blockage alarm, a leakage alarm, or abattery-low alarm.

Continuing with FIG. 1, the pneumatic connector 106 may be adapted to beaccessible at the external opening 117 of the tissue site 116 to permit,for example, removal of the dressing 110 from the tissue site 116. Insome embodiments, the pneumatic connector 106 may be directly coupled,secured, or tethered to the dressing 110, for example, by a weld 151, topermit removal of the dressing 110 from the tissue site 116 by thepneumatic connector 106. In some embodiments, the pneumatic connector106 may be directly coupled to the dressing 110 with an adhesive or anysuitable coupling device. The weld 151, adhesive, or other couplingdevice may also be used as described herein for coupling othercomponents of the system 102. In some embodiments, a portion or more ofthe pneumatic connector 106 may be formed integrally with the dressing110, or from a substrate material of the dressing 110.

The therapy device 104 may be in fluid communication with the dressing110 through the pneumatic connector 106. In some illustrativeembodiments, the pneumatic connector 106 may include a feedback lumen152, a reduced-pressure lumen 154, a conduit interface 156, and a bridge158. The pneumatic connector 106 may be supplied as part of the dressing110, and components of the pneumatic connector 106 may be added,omitted, or used in any suitable combination in other embodiments. Forexample, in some embodiments, the pneumatic connector 106 may comprise atube, lumen, pipe, or conduit that may be directly coupled in fluidcommunication with the dressing 110 without the feedback lumen 152, theconduit interface 156, or the bridge 158. Further, the feedback lumen152 and the reduced-pressure lumen 154 may be combined or formed as partof a multi-lumen conduit 160 as shown in FIG. 1. In other embodiments,the feedback lumen 152 and the reduced-pressure lumen 154 may beseparate conduits, tubes, lumens, or pipes, for example.

The feedback lumen 152 may be positioned or coupled in fluidcommunication with the sensor 140 in any suitable manner, such as,without limitation, through tubing, piping, or connectors coupled withadhesives, bonding, welding, couplers, unions, or interference fit.Similarly, the reduced-pressure lumen 154 may be positioned or coupledin fluid communication with the reduced-pressure source 136 in anysuitable manner, such as, without limitation, through tubing, piping, orconnectors coupled with adhesives, bonding, welding, couplers, unions,or interference fit. For example, the reduced-pressure lumen 154 may bein fluid communication with the reduced-pressure source 136 through thecanister 138. Thus, the canister 138 may have an outlet in fluidcommunication with the reduced-pressure inlet 148, and a canister inlet162 in fluid communication with the reduced-pressure lumen 154 fordelivering reduced pressure communicated from the reduced-pressure inlet148 to the reduced-pressure lumen 154. The reduced-pressure source 136,the reduced-pressure lumen 154, and the canister 136 may be fluidlycoupled to one another in any suitable manner, such as, withoutlimitation, through tubing, piping, or connectors coupled withadhesives, bonding, welding, couplers, or interference fit. Further, insome embodiments, the reduced-pressure lumen 154 may have a length thatis fluidly isolated from a length of the feedback lumen 152.

In some embodiments, the bridge 158 may include a bridge manifold 164that may be surrounded or encapsulated by a bridge film 166. The bridge158, including the bridge manifold 164 and the bridge film 166, may beadapted to communicate fluid between the therapy device 104 and thedressing 110. In some embodiments, the bridge film 166 may be comprisedof, or formed entirely of, a liquid impermeable material. Further, insome embodiments, the bridge film 166 may comprise a non-adherentmaterial, such as a medical drape, capable of inhibiting tissue fromadhering to the bridge 158. In some embodiments, the bridge film 166 maycomprise a breathable polyurethane film. Further, in some embodiments,bridge film 166 may comprise any of the materials recited below for thesealing member 108.

In some embodiments, the bridge film 166 may include a first bridge film166 a and a second bridge film 166 b. The bridge manifold 164 may besurrounded between the first bridge film 166 a and the second bridgefilm 166 b. The first bridge film 166 a may be sealingly coupled to thesecond bridge film 166 b in any suitable manner, such as, for example,by the weld 151. Although not shown in FIG. 1, the weld 151, or othercoupling device, may be positioned around the perimeter of the bridgemanifold 164 or at the edges of the bridge manifold 164. Similar to thebridge film 166, the first bridge film 166 a and the second bridge film166 b may be comprised of a liquid impermeable material or any of thematerials recited or referenced above for the bridge film 166. A bridgeaperture 168 may be disposed through the bridge film 166 in fluidcommunication with the bridge manifold 164.

The bridge manifold 164 may be formed from any manifold material orflexible bolster material that provides a vacuum space, or treatmentspace, such as, for example, a porous and permeable foam or foam-likematerial, a member formed with pathways, a graft, or a gauze. In someembodiments, any material or combination of materials may be used as amanifold material for the bridge manifold 164 provided that the manifoldmaterial is operable to distribute or collect fluid across a tissuesite. For example, the term manifold may refer to a substance orstructure capable of delivering fluids to or removing fluids from acrossa tissue site through a plurality of pores, pathways, or flow channels.The plurality of pores, pathways, or flow channels may be interconnectedto improve distribution of fluids provided to and removed from an areaaround the manifold. Examples of such manifolds may include, withoutlimitation, devices that have structural elements arranged to form flowchannels, cellular foam, such as open-cell foam, porous tissuecollections, and liquids, gels, and foams that include or cure toinclude flow channels. Further, the bridge manifold 164 may bebiocompatible. In some embodiments, the bridge manifold 164 may comprisea porous, hydrophobic material. In such an embodiment, the hydrophobiccharacteristics of the bridge manifold 164 may prevent the bridgemanifold 164 from directly absorbing fluid, but may allow the fluid topass through.

In some embodiments, the bridge manifold 164 may be a reticulated,open-cell polyurethane or polyether foam that is fluid permeable. Onesuch material may be the VAC® GranuFoam® material available from KineticConcepts, Inc. of San Antonio, Tex. However, a material with a higher orlower density than GranuFoam® material may be desirable for the manifold180 depending on the application. Among the many possible materials, thefollowing may be used without limitation: GranuFoam® material; Foamex®technical foam (www.foamex.com); LIBELTEX DRY WEB; LIBELTEX TDL2;LIBELTEX TL4; a molded bed of nails structure; a patterned gridmaterial, such as those manufactured by Sercol Industrial Fabrics; 3Dtextiles, such as those manufactured by Baltex of Derby, U.K.; a mass offilaments that may be adapted to provide a laminar fluid flow; aunidirectional manifold structure, such as a bundle of longitudinalfilaments; a bundle of longitudinal filaments oriented substantiallycollinear to a desired direction of fluid flow; an array of polyamidemonofilaments; a gauze; a flexible channel-containing member; and agraft.

In other embodiments, the bridge manifold 164 may comprise a materialincluding closed cells. The closed cells may not be fluidly connected toadjacent cells in the bridge manifold 164. The closed cells may beselectively disposed in the bridge manifold 164 to, for example, preventtransmission of fluids through perimeter surfaces of the manifold 164.Other layers may be included in or on the bridge manifold 164, such asabsorptive materials, wicking materials, hydrophobic materials, andhydrophilic materials. In some embodiments, the bridge manifold 164 maybe enhanced with ionic silver and anti-microbial agents.

The conduit interface 156 may be any suitable connector, such as acoupling that may be molded, machined, formed or adapted in any suitablemanner for providing fluid communication among components of the system102. For example, as shown in FIG. 1, the conduit interface 156 may beadapted to fluidly couple the bridge 158 to the feedback lumen 152 andthe reduced-pressure lumen 154. However, in other embodiments, theconduit interface 156 may be directly coupled to the dressing 110without the bridge 158. In yet other embodiments, the conduit interface156 may be coupled to the reduced-pressure lumen 154 without thefeedback lumen 152. Other embodiments are possible.

In some embodiments, the conduit interface 156 may include a flange 170surrounding or positioned around an inlet of the conduit interface 156.The inlet of the conduit interface 156 may be in fluid communicationwith an outlet of the conduit interface 156 that may be adapted to befluidly coupled to the feedback lumen 152 and the reduced-pressure lumen154. The flange 170 may be adapted to be coupled to a component of thesystem 102, such as the bridge 158 or the dressing 110, for example,with an adhesive 172 or other coupling device. The adhesive 172 may beadapted to be positioned between the flange 170 and the bridge 158 orthe dressing 110. For example, the flange 170 may be positioned aboutthe bridge aperture 168 and coupled to a surface of the bridge 158 withthe adhesive 172 to provide fluid communication among the inlet of theconduit interface 156, the bridge manifold 164, and the dressing 110.The adhesive 172 may also be used with other components of the system102. In other embodiments, the conduit interface 156 may be positionedor coupled in fluid communication with components of the system 102 inany suitable manner, such as, without limitation, through tubing,piping, or connectors coupled with adhesives, bonding, welding,couplers, unions, or interference fit.

The sealing member 108 may be adapted to cover at least a portion of thedressing 110 and the tissue site 116, and to provide a fluid seal and asealed space 174 about the tissue site 116 or between the sealing member108 and the tissue site 116. A portion of the sealing member 108 mayoverlap or cover tissue surrounding the tissue site 116, such as theepidermis 118. The dressing 110 and a portion of the pneumatic connector106, such as the bridge 158, may be sized or otherwise adapted to bepositioned in the sealed space 174, and may be secured at the externalopening 117 of the tissue site 116. The external opening 117 may provideaccess to the tissue site 116 from an exterior of the tissue site 116.The sealing member 108 may provide a fluid seal, for example, at, over,or covering the external opening 117.

The sealing member 108 may be formed from any material that may allowfor a fluid seal, such as, for example, a liquid impermeable material. Afluid seal may be a seal adequate to maintain reduced pressure, ifapplicable, at a desired site. The sealing member 108 may comprise, forexample, one or more of the following materials: hydrophilicpolyurethane; cellulosics; hydrophilic polyamides; polyvinyl alcohol;polyvinyl pyrrolidone; hydrophilic acrylics; hydrophilic siliconeelastomers; an INSPIRE 2301 material from Expopack Advanced Coatings ofWrexham, United Kingdom having, for example, a moisture vaportransmission rate or MVTR (inverted cup technique) of 14400 g/m2/24hours and a thickness of about 30 microns; a thin, uncoated polymerdrape; natural rubbers; polyisoprene; styrene butadiene rubber;chloroprene rubber; polybutadiene; nitrile rubber; butyl rubber;ethylene propylene rubber; ethylene propylene diene monomer;chlorosulfonated polyethylene; polysulfide rubber; polyurethane (PU);EVA film; co-polyester; silicones; a silicone drape; a 3M Tegaderm®drape; a polyurethane (PU) drape such as one available from AveryDennison Corporation of Pasadena, Calif.; polyether block polyamidecopolymer (PEBAX), for example, from Arkema, France; EXPOPACK 2327; orother appropriate material.

The sealing member 108 may be vapor permeable and liquid impermeable,thereby allowing vapor and inhibiting liquids from exiting the sealedspace 174. In some embodiments, the sealing member 108 may be aflexible, breathable film, membrane, or sheet having a high MVTR of, forexample, at least about 300 g/m2 per 24 hours. The use of a high MVTRmaterial for the sealing member 108 may permit moisture vapor to passthrough the sealing member 108, external to the sealed space 174, whilemaintaining the fluid seal described above. In other embodiments, a lowor no vapor transfer drape might be used. In some embodiments, thesealing member 108 may comprise a range of medically suitable filmshaving a thickness between about 15 microns (μm) to about 50 microns(μm).

In some embodiments, the adhesive 172, or other attachment device, maybe adapted to be positioned between the sealing member 108 and thetissue site 116. For example, the adhesive 172 may be positioned on orapplied to an interior facing side of the sealing member 108 for facingthe tissue site 116. In some embodiments, the sealing member 108 may besealed directly against tissue surrounding the tissue site 116, such asthe epidermis 118, by the adhesive 172. In other embodiments, theadhesive 172 may seal the sealing member 108 against a gasket or drape(not shown) adapted to be positioned between the adhesive 172 and theepidermis 118.

The adhesive 172 may be a medically-acceptable adhesive and may takenumerous forms, such as an adhesive sealing tape, drape tape, paste,hydrocolloid, hydrogel, or other suitable sealing device. The adhesive172 may also be flowable. Further, the adhesive 172 may comprise,without limitation, an acrylic adhesive, rubber adhesive, high-tacksilicone adhesive, polyurethane, or other adhesive substance. In someembodiments, the adhesive 172 may be a pressure-sensitive adhesivecomprising an acrylic adhesive with coat weight, for example, of about15 grams/m2 (gsm) to about 70 grams/m2 (gsm). In some embodiments, theadhesive 172 may be continuous or discontinuous.

Referring to FIG. 2A, in some illustrative embodiments, the dressing 110may include a fluid hub 202, a plurality of elongate fluid members 206,and a separable joint 210. The elongate fluid members 206 may bepositioned in fluid communication with the fluid hub 202. Each of theelongate fluid members 206 may include a proximal end 212, a distal end214, and an elongate side 216 between the proximal end 212 and thedistal end 214. The elongate side 216 may extend longitudinally outwardfrom the fluid hub 202. Further, the elongate side 216 may be positionednormal relative to the proximal end 212 and the distal end 214 of theelongate fluid members 206.

The separable joint 210 may be coupled between the elongate side 216 ofone of the elongate fluid members 206 and the elongate side 216 ofanother of the elongate fluid members 206. The separable joint 210 maybe configured to releasably couple the elongate side 216 of one of theelongate fluid members 206 to the elongate side 216 of another of theelongate fluid members 206. The separable joint 210 may extendlongitudinally outward from the fluid hub 202, and may be positionedalong or substantially parallel to one or more of the elongate sides216. Further, the separable joint 210 may extend from the fluid hub 202to an outer edge or periphery of the dressing 110 to facilitateseparation of the elongate fluid members 206 from one another at theouter edge and along one or more of the elongate sides 216. Theseparable joint 210 may intersect the outer edge or periphery of thedressing 110 to facilitate the separation of the elongate fluid members206 from one another. In some embodiments, the separable joint 210 maycomprise perforations between adjacent elongate fluid members 206. Inother embodiments, the separable joint 210 may comprise a score or otherdevice adapted to enhance separation of the elongate fluid members 206from one another.

In some embodiments, the dressing 110 may include the pneumaticconnector 106 shown in FIG. 1. The pneumatic connector 106 may bepositioned or coupled in fluid communication with the dressing 110 andthe elongate fluid members 206 through a dressing aperture 220. Forexample, the bridge 158 may be coupled in fluid communication with thedressing 110 at or about the dressing aperture 220. The dressingaperture 220 may be disposed through a portion of the dressing 110 andin fluid communication with the contents of the dressing 110. Further,the pneumatic connector 106 may be coupled to at least one of theelongate fluid members 206 and adapted to be accessible at the externalopening 117 of the tissue site 116, for example, to permit removal ofthe elongate fluid members 206 from the tissue site 116.

Continuing with FIG. 2A, the fluid hub 202 and the elongate fluidmembers 206 may be adapted to communicate or distribute fluid throughoutthe dressing 110. The fluid hub 202 may provide fluid communicationbetween and among the elongate fluid members 206. The fluid hub 202 maybe positioned or coupled in fluid communication with the elongate fluidmembers 206 in various configurations. For example, as shown in FIG. 2A,the fluid hub 202 may be formed integrally with the elongate fluidmembers 206, or from a portion of a substrate material of the elongatefluid members 206 or the dressing 110. Further, as shown in FIG. 2A, thefluid hub 202 may be free of the welds 151 and the separable joint 210.In other embodiments, the fluid hub 202 may be a joint, coupling, orsimilar connecting device in fluid communication between the elongatefluid members 206. Examples of various configurations are described inthe following illustrative embodiments.

Each of the elongate fluid members 206 may be adapted to communicatefluid between the proximal end 212 and the distal end 214 thereof. Insome embodiments, the proximal end 212 or the distal end 214 of theelongate fluid members 206 may be coupled to the fluid hub 202. Forexample, as shown in FIG. 2A, in some embodiments, the plurality ofelongate fluid members 206 may include a first elongate fluid member 206a, a second elongate fluid member 206 b, a third elongate fluid member206 c, a fourth elongate fluid member 206 d, and a fifth elongate fluidmember 206 e. Further, in some embodiments, the fluid hub 202 may be afirst fluid hub 202 a and the dressing 110 may additionally include asecond fluid hub 202 b, a third fluid hub 202 c, and a fourth fluid hub202 d. Although five of the elongate fluid members 206 and four of thefluid hubs 202 are shown in FIG. 2A, the dressing 110 may include anynumber of the elongate fluid members 206 and the fluid hubs 202 asdesired.

In some embodiments, the distal end 214 of the first elongate fluidmember 206 a may be fluidly coupled to the first fluid hub 202 a.Further, the proximal end 212 of the second elongate fluid member 206 bmay be fluidly coupled to the first fluid hub 202 a. The proximal end212 of the first elongate fluid member 206 a may be in fluidcommunication with the distal end 214 of the second elongate fluidmember 206 b through the first fluid hub 202 a. In some embodiments, thepneumatic connector 106 may be fluidly coupled at the proximal end 212of the first elongate fluid member 206 a. Thus, the pneumatic connector106 may provide fluid communication through or along the length of boththe first elongate fluid member 206 a and the second elongate fluidmember 206 b. In other embodiments, the pneumatic connector 106 and thefluid hub 202 may each be fluidly coupled to opposite ends of one of theelongate fluid members 206.

Additional elongate fluid members 206 may be added in an analogousmanner. For example, the distal end 214 of the second elongate fluidmember 206 b may be fluidly coupled to the second fluid hub 202 b.Further, the proximal end 212 of the third elongate fluid member 206 cmay be fluidly coupled to the second fluid hub 202 b. The proximal end212 of the second elongate fluid member 206 b may be in fluidcommunication with the distal end 214 of the third elongate fluid member206 c through the second fluid hub 202 b. Adding additional elongatefluid members 206, the distal end 214 of the third elongate fluid member206 c may be fluidly coupled to the third fluid hub 202 c. Further, theproximal end 212 of the fourth elongate fluid member 206 d may befluidly coupled to the third fluid hub 202 c. The proximal end 212 ofthe third elongate fluid member 206 c may be in fluid communication withthe distal end 214 of the fourth elongate fluid member 206 d through thethird fluid hub 202 c. Adding yet additional elongate fluid members 206,the distal end 214 of the fourth elongate fluid member 206 d may befluidly coupled to the fourth fluid hub 202 d. Further, the proximal end212 of the fifth elongate fluid member 206 e may be fluidly coupled tothe fourth fluid hub 202 d. The proximal end 212 of the fourth elongatefluid member 206 d may be in fluid communication with the distal end 214of the fifth elongate fluid member 206 e through the fourth fluid hub202 d.

Thus, the pneumatic connector 106 may be fluidly coupled at the proximalend 212 of the first elongate fluid member 206 a and in fluidcommunication with the distal end 214 of the fifth elongate fluid member206 e through the length of each of the elongate fluid members 206 a,206 b, 206 c, 206 d, 206 e. Thus, in some embodiments, an end of one ofthe elongate fluid members 206 may be fluidly coupled to an end ofanother of the elongate fluid members 206 through the fluid hub 202.Further, in some embodiments, the elongate side 216 of the elongatefluid members 206 may be fluidly sealed to preclude fluid communicationthrough the elongate side 216. Other embodiments are possible.

The fluid hub 202 and the plurality of elongate members 206 may be sizedor adapted to be positioned at the tissue site 116. In embodiments ofthe tissue site 116 including the abdominal cavity 124, the fluid hub202 may be positioned adjacent to, against, or supported by theabdominal contents 126, while the elongate fluid members 206 may bepositioned at the first paracolic gutter 128 or the second paracolicgutter 130. Other embodiments are possible. Further, in someembodiments, more than one dressing 110 may be positioned at the tissuesite 116 as desired. Further, the dressing 110 may be made visible atthe tissue site 116 under X-ray, for example, by adding a radiopaquestripe or impregnating the dressing 110 with a radiopaque material suchas barium.

Referring to FIGS. 2A-2B, in some embodiments, the elongate fluidmembers 206 may include at least one fluid lumen 230 positioned betweenthe proximal end 212 and the distal end 214 thereof. In someembodiments, the fluid lumen 230 may be positioned longitudinally influid communication between the proximal end 212 and the distal end 214.Further, the fluid lumen 230 may extend substantially parallel to theelongate side 216 and the separable joint 210.

In some embodiments, the fluid lumen 230 may be defined by at least aportion of a dressing film 234. The dressing film 234 may be comprisedof a liquid impermeable material. In some embodiments, the dressing film234 may comprise a non-adherent material, such as a medical drape, whichmay be capable of inhibiting tissue from adhering to the dressing film234. In some embodiments, the dressing film 234 may comprise abreathable polyurethane film. Further, in some embodiments, dressingfilm 234 may comprise any of the materials recited above for the sealingmember 108.

In some embodiments, the dressing film 234 may include two outer layers,such as a first dressing film 236 and a second dressing film 238. Thefluid lumen 230 may be defined between the first dressing film 236 andthe second dressing film 238. For example, the first dressing film 236may be folded or pleated with a bellows or accordion profile to form thefluid lumen 230, and coupled to the second dressing film 238 on opposingsides of the fluid lumen 230. The first dressing film 236 may be coupledto the second dressing film 238 in any suitable manner, such as, forexample, by the weld 151. The weld 151 may be continuous ordiscontinuous, and may be positioned at the top and the bottom of thedressing 110 for the orientation shown in FIG. 2A. In other non-limitingembodiments, the first dressing film 236 may be coupled to the seconddressing film 238 with other suitable coupling devices such as adhesivesor cements. The first dressing film 236 and the second dressing film 238may each be comprised of a liquid impermeable material, or any of thematerials recited above for the dressing film 234.

Further, in some embodiments, a plurality of fenestrations 242 may bedisposed through the dressing film 234. For example, the fenestrations242 may be disposed through at least one of the first dressing film 236and the second dressing film 238 in fluid communication with the fluidlumen 230.

In some embodiments, the fluid lumen 230 may carry at least of portionof a dressing manifold 246. The dressing manifold 246 may be disposed inthe fluid lumen 230. Further, the dressing film 234, such as the firstdressing film 236 and the second dressing film 238, may surround thedressing manifold 246. In some embodiments, the dressing manifold 246may comprise foam or any of the materials recited above for the bridgemanifold 164.

The pneumatic connector 106 may be in fluid communication with the fluidlumen 230 and the dressing manifold 246 through the dressing aperture220. For example, the bridge manifold 164 of the bridge 158 may bepositioned proximate to the dressing manifold 246 through the dressingaperture 220 and in fluid communication with the fluid lumen 230 and thedressing manifold 246. The dressing aperture 220 may be disposed throughthe first dressing film 236 or the second dressing film 238.

Continuing with FIGS. 2A-2B, the separable joint 210 may be, forexample, carried by, positioned on, or disposed through a portion of thedressing film 234, such as the first dressing film 236 and the seconddressing film 238. The first dressing film 236 may be coupled in anysuitable manner to the second dressing film 238 around the separablejoint 210 at the elongate side 216 of the elongate fluid members 206,for example, by the weld 151. In some embodiments, the weld 151 may becontinuous or configured to sealingly couple the first dressing film 236to the second dressing film 238. Thus, in some embodiments, the weld 151may preclude fluid communication through the elongate sides 216 beforeand after separation of the elongate fluid members 206 from one anotherat the separable joint 210. In other embodiments, the weld 151 may bediscontinuous or configured to permit fluid communication through theelongate sides 216.

The separable joint 210 and the dressing 110 may be moveable from acoupled state to a separated state. FIG. 2A depicts the separable joint210 and the dressing 110 in the coupled state with the elongate side 216of the elongate fluid members 206 releasably coupled to one another. Asillustrated in the example of FIG. 2A, some embodiments of the dressing110 may include the elongate fluid members 206 coupled end-to-endthrough one or more of the fluid hubs 202, while the separable joint 210retains the relative positions of the elongate fluid members 206 in thecoupled state. For example, the separable joint 210 may retain theelongate fluid members 206 parallel to one another in a coupled state.FIG. 3 depicts the separable joint 210 and the dressing 110 in theseparated state with the elongate side 216 of the elongate fluid members206 released or separated from one another. In the separated state, theelongate fluid members 206 may be coupled to one another end-to-end,changing the shape or footprint of the dressing 110 to an elongate orribbon-like shape, which can facilitate removal of the dressing 110through a minimally invasive exit point.

Referring to FIG. 3, when the dressing 110 is positioned at the tissuesite 116, for example, a pulling force 250 applied at the proximal end212 of the first elongate fluid member 206 a may separate at least oneof the elongate fluid members 206 from another of the elongate fluidmembers 206, positioning the separable joint 210 in the separated state.The separable joint 210 may enhance the ability of the dressing 110 tocover a larger surface area at the tissue site 116. Further, theseparable joint 210 may enhance removal of the dressing 110 from thetissue site 116 in a less invasive manner, for example, by changing theshape or footprint of the dressing 110 such that each of the elongatefluid members 206 may be removed from the tissue site 116 sequentiallyor one at a time. Such a configuration may provide for removal of thedressing 110 from the tissue site 116 through the external opening 117without requiring further surgery, an additional incision, or re-openingof the tissue site 116 after the dressing 110 has been positioned at thetissue site 116 for treatment. For example, the pulling force 250 may beapplied to the pneumatic connector 106 from exterior to the tissue site116. The pneumatic connector 106 may transfer the pulling force 250through the external opening 117 proximate to or about the dressingaperture 220, which may be positioned at the proximal end 212 of thefirst elongate fluid member 206 a, thereby moving the separable joint210 and the dressing 110 to the separated state.

Referring to FIG. 4A, depicted is another illustrative embodiment of adressing 410 suitable for use with the system 102. Similar to thedressing 110, the dressing 410 may include the fluid hub 202, theplurality of elongate fluid members 206, and the separable joint 210.However, as shown in FIG. 4A, the proximal end 212 of each of theelongate fluid members 206 may be coupled to a single fluid hub 202.Further, each of the elongate fluid members 206 may use a single fluidlumen 230 as shown in FIG. 4. In other embodiments, each of the elongatefluid members 206 may include any number of the fluid lumens 230 asdesired. Similar to the dressing 110, the dressing 410 may also includethe dressing manifold 246 positioned in the fluid lumen 230 and thefluid hub 202 of the dressing 410.

The pneumatic connector 106, described above in FIG. 1, may bepositioned or coupled in fluid communication with the dressing 410 andthe elongate fluid members 206 through the dressing aperture 220. In theembodiment of FIG. 4A, the dressing aperture 220 and the pneumaticconnector 106 may be positioned at the fluid hub 202. Thus, each of theelongate fluid members 206 may extend longitudinally outward from thefluid hub 202 and the pneumatic connector 106.

Referring to FIGS. 4A-4B, the dressing 410 may include the firstdressing film 236 sealingly coupled to the second dressing film 238around the separable joint 210 at the elongate side 216 of the elongatefluid members 206, for example, by the weld 151. FIGS. 4A and 4B depictthe separable joint 210 and the dressing 410 in the coupled state withthe elongate side 216 of the elongate fluid members 206 releasablycoupled to one another. FIG. 5A depicts the separable joint 210 and thedressing 410 in the separated state with the elongate side 216 of theelongate fluid members 206 released or separated from one another. Whenthe separable joint 210 of the dressing 410 is in the separated state,the distal end 214 of the elongate fluid members 206 may be moveablerelative to one another and capable of fanning out into a mop-likeshape. Such a configuration may permit the dressing 410 to be positionedat the tissue site 116 over a larger surface area, or provide forselective positioning of the elongate fluid members 206 in a desiredlocation at the tissue site 116.

FIG. 5B depicts the pulling force 250 being applied at the fluid hub 202of the dressing 410, illustrating the dressing 410 and the elongatefluid members 206 in a folded and gathered state suitable for removalfrom the tissue site 116 through the external opening 117. Such aconfiguration may enhance removal of the dressing 410 from the tissuesite 116 in a less invasive manner, for example, without requiringfurther surgery or re-opening of the tissue site 116 after the dressing410 has been positioned at the tissue site 116 for treatment. Forexample, the pulling force 250 may be applied to the pneumatic connector106, coupled at the fluid hub 202, from exterior to the tissue site 116.The pneumatic connector 106 may transfer the pulling force 250 throughthe external opening 117 proximate to the fluid hub 202 and about thedressing aperture 220, positioning the dressing 410 and the elongatefluid members 206 in the folded and gathered state for removal.

Referring generally to FIGS. 1-5B, in some illustrative embodiments ofoperation of the system 102, the dressing 110, 410 may be disposed at orwithin the tissue site 116, such as the abdominal cavity 124. Thedressing 110, 410 may be positioned adjacent to or in contact with thetissue site 116. In some embodiments, at least one of the elongate fluidmembers 206 of the dressing 110, 410 may be positioned in, proximate to,or in contact with the first paracolic gutter 128 or the secondparacolic gutter 130. Further, in some embodiments, the elongate fluidmembers 206 may be positioned at the tissue site 116 with the elongateside 216 of the elongate fluid members 216 being coupled to one another.For example, the dressing 110, 410 may be positioned at the tissue site116 in the coupled state described above.

In other embodiments, at least one of the elongate fluid members 206 maybe separated from another of the elongate fluid members 206 prior to orduring deployment of the dressing 110, 410 at the tissue site 116. Inthis manner, the elongate side 216 of at least one of the elongate fluidmembers 206 may be separated from the elongate side 216 of another ofthe elongate fluid members 206 and spread out or positioned across thetissue site 116 to cover a larger surface area, or a particular areathat may be desired for treatment. Additional dressings 110, 410 may beused and positioned as desired, for example, on opposite sides of theabdominal contents 126. When deployed, the dressing 110, 410 may coverall exposed viscera and may separate the viscera from contact with thewalls of the abdominal cavity 124. The dressing 110, 410 may be sizedand shaped to permit such coverage.

The sealing member 108 may be positioned and fluidly sealed about thetissue site 116 with the adhesive 172 as described above. The tissuesite 116 may be closed around the dressing 110, 410 to form the externalopening 117. The pneumatic connector 106 may be accessible through theexternal opening 117 of the tissue site 116 for connection to thetherapy device 104 or other components.

Activating the reduced-pressure source 136 may provide reduced pressureto the tissue site 116 through the pneumatic connector 106 and thedressing 110, 410. When the reduced-pressure source 136 is activated,the dressing 110, 410 may distribute the reduced pressure to the tissuesite 116 through the fluid hub 202 and the elongate fluid members 206.The reduced pressure may be distributed to the tissue site 116 throughthe dressing apertures 242 that may be associated with the fluid hub 202and the elongate fluid members 206, for example. Fluid from the tissuesite 116 may be communicated from the dressing 110, 410 to the canister138 through the pneumatic connector 106. When under reduced pressure,the dressing manifold 246 may keep the fluid lumen 230 open and incommunication with the tissue site 116.

After the tissue site 116 has been closed around the dressing 110, 410,the dressing 110, 410 may be removed from the tissue site 116post-operatively in a non-invasive or less invasive manner with minimalsurgical implications. For example, the external opening 117 at thetissue site 116 may have a length or diameter greater than about 6millimeters. In some embodiments, the external opening 117 may have alength or diameter between about 6 millimeters to about 10 millimeters,and in some embodiments, about 8 millimeters. The pneumatic connector106 may be accessed through or at the external opening 117, and thedressing 110, 410 may be removed or pulled from the tissue site 116 by,for example, applying the pulling force 250 to the pneumatic connector106 or other components of the dressing 110, 410 through the externalopening 117.

Continuing generally with FIGS. 1-5B, further described are illustrativemethods for treating the tissue site 116. In some illustrativeembodiments, a method for treating the tissue site 116 may includeproviding the dressing 110, 410. The dressing 110, 410 may include theplurality of elongate fluid members 206 and the pneumatic connector 106.The elongate fluid members 206 may include the proximal end 212, thedistal end 214, and the elongate side 216 between the proximal end 212and the distal end 214. The pneumatic connector 106 may be positioned influid communication with the elongate fluid members 206. Further, themethod may include positioning the elongate fluid members 206 across thetissue site 116, and positioning the pneumatic connector 106 through theexternal opening 117 of the tissue site 116. Further, the method mayinclude moving a fluid from the tissue site 116 along the elongate fluidmembers 206 to the pneumatic connector 206, and extracting the fluidthrough the pneumatic connector 106.

Further, the method may include removing the elongate fluid members 206from the tissue site 116 through the external opening 117 by applying aremoval force to the pneumatic connector 106. In some embodiments, theremoval force may be directed away from the tissue site 116. The removalforce may include the pulling force 250. Further, in some embodiments,the method may include pulling the dressing 110, 410 from the tissuesite 116 by the pneumatic connector 106.

In some embodiments, the tissue site 116 may be the abdominal cavity124, and positioning the plurality of elongate fluid members 206 acrossthe tissue site 116 may include placing at least one of the elongatefluid members 206 proximate to a paracolic gutter, such as the firstparacolic gutter 128 or the second paracolic gutter 130, of theabdominal cavity 124. Further, in some embodiments, the method mayinclude sealing the external opening 117 of the tissue site 116 at orabout the pneumatic connector 106 of the dressing 110.

Referring to FIGS. 1-3, in some embodiments, removing elongate fluidmembers 206 from the tissue site 116 may include removing each of theelongate fluid members 206 through the external opening 117 one at atime. In some embodiments, removing the elongate fluid members 206 fromthe tissue site 116 may include separating the separable joint 210between at least one of the elongate fluid members 206 and another ofthe elongate fluid members 206. In some embodiments, the separable joint210 may be separated between at least one of the elongate fluid members206 and another of the elongate fluid members 206 from exterior to thetissue site 116. In some embodiments, the separable joint 210 may beseparated between at least one of elongate fluid members 206 and anotherof the elongate fluid members 206 from exterior to the tissue site 116when the removal force is applied to the pneumatic connector 106.

Referring to FIGS. 1 and 4A-5B, in other embodiments, removing theplurality of elongate fluid members 206 from the tissue site 116 mayinclude removing more than one of the elongate fluid members 206 throughthe external opening 117 at the same time. In other embodiments,positioning the elongate fluid members 206 across the tissue site 116may include separating the separable joint 210 between at least one ofthe elongate fluid members 206 and another of the elongate fluid members206, and spacing the elongate side 216 of at least one of the elongatefluid members 216 apart from the elongate side 216 of another of theelongate fluid members 206. In other embodiments, removing the elongatefluid members 206 from the tissue site 116 may include gathering theelongate side 216 of each of the elongate fluid members 206 together,and removing more than one the of elongate fluid members 206 through theexternal opening 117 at the same time. In other embodiments, gatheringthe elongate side 216 of each of the elongate fluid members 206 togethermay occur when the removal force is applied to the pneumatic connector106 from exterior to the tissue site 116.

The systems, apparatuses, and methods described herein may providesignificant advantages. Among other advantages, some embodiments maysubstantially reduce complications of trauma to the abdomen. Forexample, abdominal compartment syndrome (ACS) is a complication oftrauma and some medical septic patients that has very high mortality andmorbidity. Surgical decompression remains an important intervention.Decompression is achieved by opening the midline fascia along its fulllength. While this can result in improved physiologic response, theoutcomes are not necessarily good. The open abdomen patient may bedifficult to manage, susceptible to severe complications, and canrequire very long stays in an intensive care unit. The cost of treatingthese patients can be high, at least in part because of extremely longstays in a medical facility while the abdomen remains open. Further,additional complications can arise from ACS, such as kidney failure,which can result in very expensive adjunct therapies. Some of theembodiments described herein allow an abdomen to be closed with adressing left in place to distribute negative pressure over a largemanifolding area of the cavity, and the dressing can removed aftertreatment through a single exit point rather than the main incision ofan open abdomen. The size and shape of some embodiments may also becustomizable. Additionally or alternatively, some embodiments may alsoallow fluid drainage to be customized by location, and fluid removal maybe maximized.

Although this specification discloses advantages in the context ofcertain illustrative, non-limiting embodiments, various changes,substitutions, permutations, and alterations may be made withoutdeparting from the scope of the appended claims. For example, a dressingsuch as the dressing 110 or the dressing 410 may be tapered toward anexit point to further facilitate removal. Further, any feature describedin connection with any one embodiment may also be applicable to anyother embodiment.

1.-30. (canceled)
 31. A dressing for treating a tissue site, comprising:a fluid hub; a plurality of elongate fluid members positioned in fluidcommunication with the fluid hub, each of the plurality of elongatefluid members comprising a proximal end, a distal end, and an elongateside between the proximal end and the distal end, the elongate sideextending outward from the fluid hub; and a separable joint coupledbetween the elongate side of one of the plurality of elongate fluidmembers and the elongate side of another of the plurality of elongatefluid members.
 32. The dressing of claim 31, further comprising apneumatic connector positioned in fluid communication with the pluralityof elongate fluid members.
 33. The dressing of claim 32, wherein thefluid hub and the plurality of elongate members are adapted to bepositioned at the tissue site, and wherein the pneumatic connector isadapted to extend through an external opening of the tissue site. 34.The dressing of claim 31, wherein the proximal end or the distal end ofthe plurality of elongate fluid members is coupled to the fluid hub. 35.The dressing of claim 31, wherein each of the plurality of elongatefluid members further comprises at least one fluid lumen positionedbetween the proximal end and the distal end.
 36. The dressing of claim35, wherein the at least one fluid lumen is positioned longitudinally influid communication between the proximal end and the distal end.
 37. Thedressing of claim 35, wherein the at least one fluid lumen is defined byat least a portion of a dressing film, wherein the dressing filmcomprises a first dressing film and a second dressing film, and whereinthe at least one fluid lumen is defined between the first dressing filmand the second dressing film.
 38. The dressing of claim 37, wherein thedressing film is comprised of a liquid impermeable material.
 39. Thedressing of claim 37, wherein the first dressing film is coupled to thesecond dressing film on opposing sides of the at least one fluid lumen.40. The dressing of claim 37, further comprising a plurality offenestrations disposed through at least one of the first dressing filmand the second dressing film in fluid communication with the at leastone fluid lumen.
 41. The dressing of claim 35, wherein the at least onefluid lumen carries at least a portion of a dressing manifold.
 42. Thedressing of claim 31, wherein the separable joint is configured toreleasably couple the elongate side of one of the plurality of elongatefluid members to the elongate side of another of the plurality ofelongate fluid members.
 43. The dressing of claim 37, wherein theseparable joint is carried by a portion of the first dressing film andthe second dressing film, and wherein the first dressing film issealingly coupled to the second dressing film around the separablejoint.
 44. The dressing of claim 32, wherein the pneumatic connector iscoupled to at least one of the plurality of elongate fluid members andadapted to be accessible at an external opening of the tissue site topermit removal of the plurality of elongate fluid members from thetissue site.
 45. (canceled)
 46. A method for treating a tissue site,comprising: providing a dressing, comprising: a plurality of elongatefluid members including a proximal end, a distal end, and an elongateside between the proximal end and the distal end, and a pneumaticconnector positioned in fluid communication with the plurality ofelongate fluid members; positioning the plurality of elongate fluidmembers across the tissue site; positioning the pneumatic connectorthrough an external opening of the tissue site; moving a fluid from thetissue site along the plurality of elongate fluid members and to thepneumatic connector; extracting the fluid through the pneumaticconnector; and removing the plurality of elongate fluid members from thetissue site through the external opening by applying a removal force tothe pneumatic connector.
 47. The method of claim 46, wherein the removalforce comprises a pulling force directed away from the tissue site. 48.The method of claim 46, wherein removing the plurality of elongate fluidmembers from the tissue site comprises removing each of the plurality ofelongate fluid members through the external opening one at a time. 49.The method of claim 46, the dressing further comprising a separablejoint coupled between the elongate side of one of the plurality ofelongate fluid members and the elongate side of another of the pluralityof elongate fluid members.
 50. The method of claim 49, wherein removingthe plurality of elongate fluid members from the tissue site comprisesseparating the separable joint between at least one of the plurality ofelongate fluid members and another of the plurality of elongate fluidmembers.
 51. The method of claim 50, wherein the separable joint isseparated between at least one of the plurality of elongate fluidmembers and another of the plurality of elongate fluid members fromexterior to the tissue site.
 52. The method of claim 50, wherein theseparable joint is separated between at least one of the plurality ofelongate fluid members and another of the plurality of elongate fluidmembers from exterior to the tissue site when the removal force isapplied to the pneumatic connector.
 53. The method of claim 46, whereinremoving the plurality of elongate fluid members from the tissue sitecomprises removing more than one of the plurality of elongate fluidmembers through the external opening at the same time.
 54. The method ofclaim 49, wherein positioning the plurality of elongate fluid membersacross the tissue site comprises separating the separable joint betweenat least one of the plurality of elongate fluid members and another ofthe plurality of elongate fluid members, and spacing the elongate sideof at least one of the elongate fluid members apart from the elongateside of another of the elongate fluid members.
 55. The method of claim54, wherein removing the plurality of elongate fluid members from thetissue site comprises gathering the elongate side of each of theplurality of elongate fluid members together and removing more than oneof the plurality of elongate fluid members through the external openingat the same time.
 56. The method of claim 55, wherein gathering theelongate side of each of the plurality of elongate fluid memberstogether occurs when the removal force is applied to the pneumaticconnector from exterior to the tissue site.
 57. A method for removing adressing from a tissue site, comprising: providing the dressingpositioned at the tissue site, the dressing comprising: a plurality ofelongate fluid members including a proximal end, a distal end, and anelongate side between the proximal end and the distal end, the pluralityof elongate fluid members positioned across the tissue site, a pneumaticconnector positioned in fluid communication with the plurality ofelongate fluid members, the pneumatic connector extending through anexternal opening of the tissue site, and a separable joint coupledbetween the elongate side of one of the plurality of elongate fluidmembers and the elongate side of another of the plurality of elongatefluid members; removing the plurality of elongate fluid members from thetissue site through the external opening by applying a removal force tothe pneumatic connector.
 58. The method of claim 57, wherein theseparable joint is separated between at least one of the plurality ofelongate fluid members and another of the plurality of elongate fluidmembers from exterior to the tissue site when the removal force isapplied to the pneumatic connector.
 59. The method of claim 57, whereinremoving the plurality of elongate fluid members from the tissue sitecomprises removing each of the plurality of elongate fluid membersthrough the external opening one at a time.
 60. The method of claim 57,wherein removing the plurality of elongate fluid members from the tissuesite comprises gathering the elongate side of each of the plurality ofelongate fluid members together and removing more than one of theplurality of elongate fluid members through the external opening at thesame time.
 61. A method for placing a dressing at a tissue site,comprising: providing a dressing, comprising: a plurality of elongatefluid members including a proximal end, a distal end, and an elongateside between the proximal end and the distal end, and a pneumaticconnector positioned in fluid communication with the plurality ofelongate fluid members; positioning the plurality of elongate fluidmembers across the tissue site; positioning the pneumatic connectorthrough an external opening of the tissue site; and wherein positioningthe plurality of elongate fluid members across the tissue site comprisesspacing the elongate side of at least one of the elongate fluid membersapart from the elongate side of another of the elongate fluid members.62. (canceled)